| NPI | 1710500178 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: WA LL61066761) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MT SLP-SP-LIC-8800) |
| Enumeration Date | 2020-05-20 |
| Last Update Date | 2020-05-20 |